Proceedings of the 11th International Association of Veterinary Rehabilitation and Physical Therapy Symposium

physical

Background: Transcutaneous electrical nerve stimulation (TENS) is often used as a pain-relieving treatment in dogs.Despite its frequent use, the evidence for its clinical efficacy is sparse.However, it has been shown that treatment with TENS, on five dogs with arthrosis, increased weight bearing up to 120 min after treatment [1].This randomized, controlled cross-over study aimed to investigate the effect of TENS on physical activity in dogs with chronic pain from the locomotor apparatus.

Materials and methods:
The study included 14 dogs with a low to moderate degree of lameness and age over 1 year.The dogs were diagnosed with pain from the locomotor apparatus by clinical examination before inclusion in the study.The dogs were treated with high-frequency TENS set at a constant current of 80 Hz and 100 µs for 45 min, once daily for eight or ten consecutive days.The electrodes were placed on the skin adjacent to the most painful joint, assessed by clinical examination, and confirmed by journal records.
Results: There was a washout period between the randomized interventions active treatment and placebo (Fig. 1).The effect of TENS was evaluated by obtaining activity level data with an activity monitor (ActiGraph GT3X +) before and after treatment.Registrations were conducted for the full intervention (8 to 10 days) and a baseline (2-13 days).

Figure 1 (abstract O.01) Study design
The activity monitor data was processed in Matlab by a person blinded to the order of treatments.Counts per minute were analyzed and the activity was divided into four categories: sedentary, light, moderate, and vigorous [2].A one-sided paired t-test was performed in Excel and the significant P value was set to < 0.05.Preliminary results show significant changes were seen in the light activity category (P = 0.02).

Open Access
Background: Muscle strength is an essential part of physical function and may affect daily physical activity.Evaluating muscle strength is vital to assess a dog´s general physical condition and to evaluate progress in physical training and rehabilitation programs.There are few ways to evaluate muscle strength directly in animals.Limb circumference, as assessed with a tape measure, has been shown to provide reliable measurement of the proximal antebrachium and possibly the thigh [1,2].For thigh circumference, the method's validity has been questioned [3]; furthermore, studies have not been conducted on standing dogs.Since the tape measure is a simple and affordable tool to measure the circumference, it is important to investigate its reliability.The present study aimed to determine, in a clinical setting, the inter-and intra-rater reliability of limb circumference measures in standing dogs.Material and methods: Circumferential measurements were conducted on 37 healthy dogs of various breeds, sex, and age.The dogs were standing squarely, and measurements were performed with a tape measure (dynamometer) at four standardized locations: lower brachium, upper antebrachium, lower thigh, and upper crus (Fig. 1).Measurements were conducted the same day, in triplicates by two examiners who were blinded to the measurement results.Inter-rater reliability was calculated as the intra-class correlation (ICC) between observers for the exact measurement.In contrast, intra-rater reliability was the ICC) between subsequent measurements by the same examiner.ICCs with P < 0.05 were considered statistically significant.Results: Results showed overall high inter-rater reliability (ICCs ≥ 0.091, P < 0.01) and very high intra-rater reliability (ICCs ≥ 0.99, P < 0.01).Interrater reliability was highest for antebrachium (ICC ≥ 0.99, P < 0.01) and somewhat lower for thigh (ICC ≥ 0.91, P < 0.01).

Conclusion:
Results indicate that tape measures represent a promising tool for estimating limb circumference in standing dogs.We suggest that it may be used to estimate muscle mass when direct measurements are unavailable.Future studies should investigate the correlation between tape measurements of limb circumference and muscle mass in dogs.
Background: Cerebellar hypoplasia (CH) is a congenital neurologic condition caused by the inadequate development of the cerebellum which is responsible for fine-tuning motor movements [1].This condition may lead to head tilt, ataxia, nystagmus, strabismus, and other neurological deficits, including an inability to move or walk normally for patients [2].This pain-free condition remains stable, so the patient can live an acceptable quality of life if able to maintain basic functions such as eating, drinking, moving, and resting comfortably [3].These dogs can usually learn to compensate for their condibilitation represents an option for those patients to improve their quality of life.Materials and methods: A 4-month-old Australian shepherd was presented for rehabilitation management with presumed CH following his evaluation by a neurologist.Clinical presentation included: head tilt towards the left side, intermittent positional nystagmus, non-ambulatory severe ataxia, and increased reflexes and extensor tone in all limbs with a lack of tonus inhibition on the left side (Fig. 1).The owner's goal was to improve gait function and body orientation to ensure optimal quality of life.The rehabilitation protocol included mobilizations, balance exercises, assisted walking, and underwater treadmill (UWTM) sessions.Emphasis was placed on the ability to turn left for this patient since this was his larger deficit, and he turned right almost exclusively.Multiple rehabilitation strategies were employed to teach him how to turn left including direct stimulation using voice, toys, and food, and indirect techniques using obstacles.Facilitators such as gait exercises on a mild down slope had a positive effect to help this patient turn left.Sessions were repeated daily for a duration of 20 min.A four-wheeled cart was prescribed to promote independent mobility and trunk stabilization; modifications to the cart included side cushioning and straps to prevent skin breakdown due to tremors and exaggerated movements (Fig. 2).Results: A Bailey chair and a soft diet prescription were provided to promote a safe eating setup in the context of megaesophagus (Fig. 3).During UWTM sessions, a life vest adaptation was provided to hold the head in an upper position (Fig. 4).

Conclusion:
Outcome assessments gathered after 3 months of continuous rehabilitation plan included decreased head tilt, improved motor function, and independent ambulation achieved with a four-wheel cart for short distances (up to 15 feet).Therefore, rehabilitation should be considered for patients presenting CH to improve motor function and quality of life.
Background: Osteoarthritis (OA) of the stifle is common.Despite good conservative management, many dogs continue to suffer from pain associated with OA.Therapeutic laser is popular as a potential adjunct therapy, but there is little documentation of efficacy in clinical patients, although it reportedly reduces pain and lameness in arthritic elbow joints [1].The purpose of this study was to evaluate the use of a Class IV laser on OA of the stifle using objective force platform evaluation.We hypothesized that daily treatment with a Class IV laser would reduce lameness and increase weight bearing compared to sham treatment in a paired crossover design.Materials and methods: Nine dogs with experimentally induced stifle OA were used in this study.All dogs had surgical transection of one cranial cruciate ligament and immediate repair with either a lateral fabella tibial suture or a tibial plateau leveling osteotomy and were chronically affected with stifle OA for greater than 12 months.To qualify for the study, dogs must have had a difference of peak vertical force (PVF) between sides of > 5%.Dogs were randomized to receive either initial laser or sham treatments.Weekly ground reaction force measurements were made for 28 days.After the initial 28-day assessment, a 28-day wash-out period was given, and dogs switched groups.Measurements were again made weekly for another 28 days.Treatment with the laser or sham treatments were performed five out of seven days each week, using a 980 nm laser.Limbs were clipped, and the laser dosage was 10 J/cm 2 , using 3 watts of power.Results: Statistical analysis using a 2-way ANOVA did not reveal any significant differences in peak vertical force between treatment and control groups (Table 1) or symmetry index between the two pelvic limbs over the 28-day study period (P > 0.05).Conclusion: Class IV laser therapy, used in the treatment protocol described here, did not provide benefits regarding improved ground reaction forces.Further studies evaluating different treatment protocols, including other doses or frequency of treatment, are warranted.Background: The study's aim was to assess and compare left and right-side flexion and extension of the glenohumeral, humeroulnar/ humeroradial, coxofemoral, and femorotibial joints and for laterality ROM differences.Research into musculoskeletal imbalances and differences between left and right-hand side joint ROM in Canis familiaris is limited [1].Relationships between thoracic and pelvic limb structure and function have been observed, however, there is little peerreviewed research [2].Passive joint ROM provides proof that particular joints can move in their physiological planes of motion without the influence of muscle activity.Materials and methods: Siberian huskies (n = 18) from one kennel were selected to minimize genetic and environmental effects.Dogs were of mixed gender (55.5% males (n = 10) and 45.5% females (n = 8)), aged > 1 year (mean ± S.D. (range)): 5.1 ± 3.2 (1.4-11.8).Joint ROM was measured using goniometry, a validated, non-invasive method in dogs [3], by the same investigator previously tested for acceptable repeatability of measurement.Dogs were conscious and placed in a standing position [4], specific bony landmarks were identified before triplicate measures of joint flexion and extension were taken on both sides of each dog for shoulder, elbow, hip, and stifle joints.Mean values of the measures were computed and tests Pearson Correlation Coefficient compared laterality of joint ROM, gender, and ages effects.

Background:
The presence of potentially pathogenic bacteria on surfaces in veterinary clinics is problematic for animals and people.Animals in these clinics often touch contaminated surfaces with their feet, noses, and mouths [1].Fecal matter likely contaminates these surfaces, which presents the opportunity for shedding of Clostridium perfringens and Clostridium difficile [2].There is evidence that bacterial strains originally thought to be pathogenic in animals, such as Staphylococcus intermedius, may also cause infections in humans [3].Studies of Methicillin-resistant Staphylococcus aureus (MRSA) present the possibility of pets harboring MRSA contracted from humans that could lead to cross-transmission back to humans [4].The focus of this study was to determine the contamination of environmental surfaces by potentially pathogenic bacteria in five veterinary rehabilitation clinics.Materials and methods: Sampling involved using 30 double transport swabs (Fisherbrand, with Stuart's liquid medium) from 13 different locations in each clinic (Table 1).The swabs were then placed on ice and transported to a microbiology lab (within three hours of collection) for processing.

Results:
The most prominent species cultured from the clinics was C. difficile (Table 1).Enteric bacteria were the second most encountered bacteria, found on 33% of swabs from the sample sites.Both MRSA and S. intermedius were found on approximately 10% of swabs collected.Of the clinic sites sampled, the largest number of positive swabs was from the floor and air ventilation sites (HVAC) (Table 1).For water samples collected from the underwater treadmills, total bacterial counts ranged from an average of 380 to 2,880 CFU/ml.Conclusions: Clostridium difficile was the most prominent bacterial species on environmental surfaces in these clinics, with clinic floors and HVAC systems having the highest levels of contamination.Despite posing few risks, these bacteria may be major pathogens for humans.S. intermedius tends to be more pathogenic for dogs, and notable levels of Staphylococcus species were present throughout the clinics sampled.Targeted cleaning and disinfecting, along with frequent monitoring of veterinary rehabilitation facilities, may reduce risks of infection in both animals and humans in clinics.
Background: Lameness is the leading cause of elimination from endurance competitions [1][2][3][4][5][6][7][8], and within British national competitions, hindlimb lameness is more common than forelimb lameness [9].Evidence supports the co-existence of thoracolumbar back pain and hindlimb lameness in horses [10].This study aimed to identify if thoracolumbar back pain during endurance competition was a risk factor associated with elimination, more specifically lameness elimination, from competition.

Materials and methods:
The study occurred across eight days of British national endurance competitions across five different venues in 2021.During the veterinary inspection, in addition to assessing lameness, when palpating the epaxial musculature, veterinarians were asked to grade the horses backs based on a categorical scale [11].Pearson's chi-squared tests were used to identify significant differences between back palpation scores and successful or unsuccessful outcomes.Univariable models were constructed for risk factors for two results (a) eliminated vs. not eliminated and (b) lame vs. not lame.Risk factors were considered significant for multivariable analysis with a P value of ≤ 0.1.Multivariable logistic regression models were constructed using a backward stepwise process with an omnibus test of model coefficients applied at each step.
Results: Across all rides, 44 horses started with an asymmetrical back palpation score; of those, 29.5% (n = 13) were subsequently eliminated for lameness.In comparison, 8.5% (n = 32) of the horses which started with a symmetrical back palpation score (n = 377) were eliminated lame.A significant difference was found (P < 0.001) between horses who palpated a score of 0-2/5 and horses who palpated a higher score of > 3/5, whether they were eliminated or not and whether they were lame or not.Horses who presented with an asymmetrical back palpation score throughout the ride were at increased odds of elimination from the competition (Odds ratio 2.31, 95% CI Background: During an endurance competition, horses must pass a series of veterinary inspections to complete the ride [1,2].Within these veterinary inspections, the horse's epaxial musculature is palpated.There have been no studies looking at the inter-rater reliability of back palpation during any equestrian competition.This study aimed to test the inter-rater reliability of back palpation during an endurance competition using a categorical grading scale [3].Materials and methods: Nineteen horses of mixed breeding entered into a pleasure ride (13-24 km) run by Endurance GB were included in the study.All horses were presented to a veterinary inspection consisting of a trot in hand, 30 m away from and back to two licensed veterinarians.Having been declared fit to start the competition, the horses had their thoracolumbar epaxial musculature palpated by the veterinarian.They graded based on the scale described by Merrifield-Jones et al. [3].The veterinarian gave their palpation score for both left and right sides of the epaxial musculature to a scribe.A fourth-year veterinary student blinded from the veterinary surgeon's scores then palpated the musculature and gave their scores to the recorder.The horses completed their ride (13-34 km), and the veterinary inspection, including epaxial palpation, was repeated.Inter-rater reliability of palpation scores was tested with a Fleiss' kappa analysis series.

Conclusion:
This study identified that the categorical rating scale used for manual palpation of the equine epaxial musculature during endurance competition has excellent inter-rater reliability between veterinary surgeons and veterinary students.To establish the validity of the scale during competition, further information and testing is necessary.
Background: Bone spavin (BS) is chronic tarsus osteoarthritis that involves the tarsometatarsal joint and the distal intertarsal joint with involvement of the proximal intertarsal joint [1].Horses can suffer from bone spavin and it is the most common cause of hind limb lameness [2].
HILT is able to bring a high amount of light energy to deep tissues in a short time [4], and stimulate areas such as the large joint [5].HILT has been used for pain management in human musculoskeletal disorders such as osteoarthritis [6].Materials and methods: Case records of 11 horses of mean age 12.5 ± 2.7 years diagnosed with BS were included in the study.None of the horses had been treated or shoed for BS in the last 6 months.Involved tarsal joints were treated using class IV laser with 808 nm and 980 nm wavelengths delivered simultaneously.Each horse received 10 treatments during a 14-day period with the same HILT parameters.Pretreatment and post-treatment orthopedic and radiographic examinations were performed to assess changes in lameness grade, spavin test grade, and bone structure.Lameness was scored using the American Association of Equine Practitioners 0-5 scale [7] and spavin test was scored according to Stashak [8].
Results: At post-treatment orthopedic examination 36% of the horses had improved two lameness grades, 36% of the horses had improved one lameness grade and 28% of the horses did not show any improvement (Fig. 1).For post-treatment spavin test results one grade improvement was observed in 45% of the horses and 55% of the horses showed the same spavin test grade as before treatment (Fig. 2).Follow-up radiographs when compared to initial radiographs did not show any significant changes.Background: The mm multifidus cross-sectional area is decreased on the side and level of symptoms or pathology [1,2].Muscle asymmetry, coupled with clinical signs that are level-or side-specific, could provide vital information about the presence of undetected symptomatic pathology [3].The study aimed, to define the prevalence of asymmetry in Flat and National Hunt Racehorses; secondly, to determine if this differed between disciplines.Finally, to determine if there is a relationship between asymmetry and evidence of back pain or dysfunction indicative of presumptive underlying spinal pathology.Materials and methods: Thoroughbred racehorses in full training from Flat and National Hunt trainers were recruited.Injured, resting, or recently retired horses were excluded.Clinical assessment of the back included observation (evidence of saddle misfit, conformation, and epaxial muscle atrophy), palpation, and spinal range of motion.Horses were assigned a back pain score and clinical assessment cumulative score each.A Flexible Curve Ruler was used to measure thoracolumbar shape at T13, T18, and L4.Each shape was traced, photographed, and imported into an image analysis program.Each side was traced three times, the mean of these being used to calculate the percentage difference between left and right sides at each vertebral level.Horses that fell between 0 and 2.99% were considered symmetrical; ≥ 3% was considered asymmetrical.

Conclusion:
Asymmetry cannot be used as a standalone marker to determine the presence of current or potential symptomatic pathology.It is likely a large percentage of racehorses will have incidental pathological spinal findings; it cannot be assumed that every pathology is or will be, symptomatic or clinically significant [2,4].Asymmetry measurements coupled with clinical examination should form part of a battery of functional and performance tests of individual racehorses.

Results:
We received 1615 replies to the questionnaire.After data cleaning, 1582 dogs (98%) were left for analysis.The number of sports performed by each dog varied from one to five.Most common was participation in one (n = 762, 48%) or two (n = 548, 29%) sports).Three dogs competed in five sports disciplines, 51 dogs in four disciplines, and 222 dogs (14%) in three disciplines.Of the dogs practicing only one discipline, 39% (n = 297) were considered specialized as they actively trained in that discipline for ≥ 10 months per year.Similar proportions of working dogs (n = 83, 5.2%) and agility dogs (n = 83, 5.4%) were specialized.These proportions decreased slightly among obedience dogs (n = 65, 4.1%) and rally obedience dogs (n = 60, 3.8%).

Conclusion:
Our findings provide valuable insights into sport-specific training patterns among active sports dogs in Sweden.Sport specialization may positively and negatively affect movement skills.Further studies regarding the risk and protective factors of injuries in the sporting and working dogs are required.

PO. 03 Factors affecting the incidence of injury in agility dogs
Jenny Coates 1  1 School of Veterinary Science and Medicine, University of Nottingham, UK Correspondence: Jenny Coates (jenny.coates@nottingham.ac.uk)Acta Veterinaria Scandinavica 2023, 65(Suppl 1): PO. 03 Background: Dog agility is growing in the UK; as the sport progresses and agility dogs perform closer to their physical limits, the risk of injury increases.There is little research on the mechanisms of injury and the factors that influence whether a dog will sustain an injury at some point in their career.Owners are currently not encouraged to make choices that prevent injury.To shed light on potential causative factors, identify future avenues of investigation, and assist owners with increasing the physical resilience of their dog, this study aims to investigate variables that impact on the incidence of injury.Injuries may have a detrimental effect on the dogs' agility careers as injured dogs will miss training and competition during the rehabilitation and recovery phase [1], and there is no guarantee that they will fully return to sport.Background: Osteoarthritis is a chronic, debilitating condition that can affect the quality of life in dogs [1].Previous studies have shown improved overall comfort with a modified foam mattress [2].To the authors' knowledge, this has not been studied in canines.This study objected to determine if the therapeutic mattress improved joint mobility, increased activity, and enhanced the quality/quantity of sleep in dogs with confirmed osteoarthritis.Materials and methods: 40 dogs over 3 years old were enrolled in the study.Veterinary examination and radiographs were used to confirm osteoarthritis.Client-specific outcomes were obtained, with activity monitors placed ten days before the initiation of the mattress to establish baseline activity.The dogs returned on day 0, and the therapeutic bed was initiated.Dogs returned for evaluation on Day 28.Clients completed the Canine Orthopedic Index (COI), Canine Brief Pain Inventory (CBPI), Global Assessment of Change questionnaire (GAC), and Canine Symptom Assessment Scale (CSAS) [3].

Materials and methods
Results: 40 dogs, 17 females, and 23 males, were included in the study analysis.The mean age for the dogs was 8.48 years (range from 3 to 12 years).The mean body weight was 41.1 kg (94.5 lbs.) with a capacity of 30.2 kg (66.4 lbs.) to 83.2 kg (183 lbs.).The most represented breeds were mixed breed (n = 14) and Labrador Retrievers (n = 7).The COI questionnaire evaluated the stiffness, gait, function, and quality of life of the participant dogs.All domain assessed scores were compared using t-tests, or Wilcoxon signed rank depending on the data type and were statistically significant ( P < 0.05).Owners reported a 12.5% improvement in joint stiffness and a 17.6% improvement in joint function.A modification in gait and the quality of life was also noted at 9.6% and 15.1%, respectively.Pain severity, pain interference, and quality of life were assessed through the use of the CBPI questionnaire.A 21.6% improvement was noted for pain severity, as well as a 14.3% improvement for pain interference.The activity monitor data did not show a statistically significant change compared to the baseline.

Conclusion:
Owners of osteoarthritic dogs that had access to the therapeutic mattress for 28 days reported significant improvement in their dog's joint stiffness, joint function, gait, pain, pain severity, pain interference, pacing, panting, and quality of life.
Background: Canicross, a cross country race practiced by a man-dog pair, is a relatively new sport in Brazil and is attracting more and more fans.The study analyzed the profile of Canicross practitioners in Brazil.
A semi-structured questionnaire consisting of 33 questions was used: seven related to the handler and 26 to the dogs.

Materials and methods:
A semi-structured questionnaire consisting of 33 questions was used: seven related to the handler and 26 to the dogs.
Results: Of the total handlers, 53.3% are women, 64% have practiced the sport for at least 5 years and 52.3% trained with a personal trainer.Of the dogs, 62.6% were females, 60% were between one and four years old and the Mixed Breeds were the majority with 34.6%; as for the health of the animals, 80% of the handlers stated that they did not carry out veterinary monitoring aiming at Canicross.6.6% of the animals had sports-related injuries and 80% of these cases received veterinary treatment.The percentage of animals that were not subjected to any type of specialized monitoring aiming at the sport was quite high (80%).

Conclusion:
Handlers are concerned with the prevention and treatment of injuries and that these precautions are widely known, this is not reflected when it comes to dogs.More studies should be carried out, but the originality of this work was essential for both sports lovers and veterinary professionals to develop strategies so that dogs can practice this sport with more safely.

PO. 06 Exploring the information and support needs of owners caring for a dog with canine cognitive dysfunction
Daisy de Meester 1 , Gillian Tabor Background: Canine cognitive dysfunction (CCD) is an age-related neurodegenerative disease, sharing similar symptoms to Alzheimer's disease in humans [1].While it is recognized that CCD has a large impact on the owner and the dog [2], there is a lack of research identifying support and information provided to those caring for dogs with CCD and its effectiveness in enabling owners to provide care.
The objectives of this qualitative study were to explore the information and support provided to dog owners at the time of CCD diagnosis.Additionally, this study aimed to critically evaluate how different sources have impacted owners, how they support their dogs, and make recommendations to improve the support offered.Materials and methods: Sixty-six owners of dogs with CCD completed an online survey, gaining dog and owner demographic information, exploring participant's experience of CCD, support, and information options at and following diagnosis.Data were transcribed and analyzed using descriptive statistics and inductive grounded theory.Semi-structured interviews were completed with six participants, focusing on the owner's experiences of diagnosis, and the effectiveness of strategies for providing information and support.Results were transcribed and analyzed using thematic analysis.
Results: Owners report many stressors when caring for a dog with CCD.While 98.48% (n = 65) of respondents reported feeling that improving their understanding of CCD had been beneficial in supporting their dog, it was often a challenging and frustrating experience to gain accurate information and consistent support.The interviews identified six key themes: impacts of CCD, the knowledge of diagnosis, experience following diagnosis, seeking answers, approach matters, and awareness and options (Fig. 1).A multimodal approach is required to support owners of dogs with CCD effectively; key areas include symptom awareness and planning for a decline in health.

Figure 1 (abstract PO. 06) Schematic diagram of interlinking themes
Conclusion: Practical support and information are essential in helping owners care for dogs with CCD, including managing symptoms that can lead to caregiver strain and associated health implications for the owner.This research highlighted that owners struggle to get accurate information and support; however, when appropriate and easily accessible, support and information can be effective at helping them to navigate the stressors of CCD.Providing accessible and focused 'multimodal' resources is vital to ensuring the well-being of both the owner and the dog with CCD.

PO. 07 The use of laser class IIIB as an aid in injury healing
Letícia Nosdeo Background: Photobiomodulation is a therapy of choice for injury treatment because it can considerably stimulate the formation of new capillaries, leading to better tissue oxygenation, which in turn accelerates the healing process [1,2].The three phases present in the process of tissue repair suffer positive influence after using a laser.Besides the therapy having a powerful analgesic effect, several studies indicate an essential role of photobiomodulation in reducing inflammation and edema [3,4].Materials and methods: Male canine patient, Labrador Retriever, 10 years old, was seen with a previous history of excision of a nodule with unknown characteristics without histopathological examination, in the right pelvic limb region, without enough surgical margin for suture, thus occurring healing by second intention.The wound that was formed extended throughout the medial region of the thigh, causing the patient a lot of discomforts.Photobiomodulation was used as an auxiliary technique to accelerate the healing process and bring greater quality of life and comfort to the patient.The therapy began with the application of a therapeutic laser, through the DMC-Theravet ® device, using the red laser, with a wavelength of 660 nm, at a dose of 4J per point, at equidistant points every 2 cm, along the entire length of the lesion, with intervals between applications of 2 to 3 days, until complete closure.
Results: After 22 applications of the therapeutic laser, within 3 months, complete closure of the wound was observed.Background: Palliative care is a clinical approach that aims to take care of patients with life-threatening illnesses, through appropriate symptom control, rehabilitation, and family support.This kind of care should be present from the disease diagnostic simultaneously to the curative treatment, and its relevance increases along with disease progression and the proximity of the final period of life.To provide this care in a global and holistic way, the multi-professional approach with an interdisciplinary focus is necessary to build the patient and family care plan.Rehabilitation contributes to maintaining patient functionality and autonomy, which often declines with the disease progress and directly affects the disease experience.In this context, physical therapy promotes improving mobility, blood flow, and motor coordination, treating functional limitations, accelerating healing, and reducing pain through physical and manual treatments.Besides its crucial role in controlling symptoms such as dyspnea, fatigue, and anorexiacachexia syndrome beyond other frequent symptoms in cancer patients.

Methods and methods:
We developed a Veterinary Palliative Care Service, with simultaneous sessions with physical therapists, acupuncturists, and palliative veterinary veterinarians, with the goal of increasing offerings to animals with severe illnesses and injuries, such as cancer, advanced arthritis, and mobility concerns, kidney disease, heart disease beyond others.Beyond clinical treatment and controlling symptoms, our service is also focused on supporting caretakers in their experiences through the disease process of their pets.
Results: In our experience with multidisciplinary veterinary palliative care service, since April 2019, patients experienced less frequent and intense symptoms, less frequent and shorter hospital internment, and longer lifetime, compared with patients we treat in conventional services and compared to literature reports.

Conclusion:
Even though more objective measures, such as the quality of life, mobility, and pain scales, must be implemented to improve the assessment of measurable results achieved through multi-disciplinary veterinary palliative care service, our experience and caretaker's feedback strongly encourage us to expand our service and spread our expertise, contributing to provide softer experiences to caretakers and pets in their end-of-life period.

PO. 10 Caregiving burden and the role of veterinary physiotherapy in the management of canine non-surgical neurological disease
Lucy Dawson Background: It was recently suggested that individuals caring for sick companion animals experience similar stressors as those caring for a friend or relative -a phenomenon known as 'caregiving burden' [1].
Assistance for these individuals does not currently exist in veterinary medicine in the same way as in human medicine.Stress for the owner, alongside the reduced quality of life for their pet, increases the consideration of end-of-life decisions, with neurological disease cited as a leading cause of euthanasia in dogs over 3 years of age [2].Veterinary physiotherapy has the potential to offer the required support for owners.

Materials and methods:
This study used qualitative methods to examine the impact on owners of caring for a dog with a non-surgical neurological condition, and how Veterinary Physiotherapy influenced their experience.Owners of dogs with relevant medical conditions were invited via social media groups and email to complete an online survey.Respondents were further invited to partake in semi-structured interviews to explore their experiences in more depth.Interviews were transcribed and thematic analysis was performed to identify important themes.
Results: 53 UK dog owners completed the survey.Data showed owners attending more appointments with a Veterinary Physiotherapist were significantly more likely to agree it helped their pet.Interactions with vets played a key role in owners' decisions to attend physiotherapy with their pets.Two owners were interviewed following survey completion.Three themes were developed; the physical, mental, and emotional challenges to caring for a disabled dog, how owners often relied upon their own research and social media support groups, and the positive experiences of utilizing veterinary physiotherapists.

Conclusions:
This study supports previous research that the caregiving burden exists for owners of sick companion animals.Owners benefit from seeking support from those with shared experience and knowledgeable professionals.Reputable online resources to direct owners to are vital.Veterinary Physiotherapists should be incorporated into a multidisciplinary veterinary team when managing non-surgical neurological diseases in dogs and veterinary surgeons should support owners as well as their canine patients when managing these cases.
The application of a stethoscope to characterize joint pathology may decrease the cost of diagnostics for joint injury and disease and may be a minimally invasive tool for the diagnosis and monitoring of joint disease.It is possible that distinct audible sounds such as popping, clicking, or grinding may be auscultated in joints and aid in assessment.We report cases of audioarthrology evaluation of hip joint pathology.
Materials and methods: A digital stethoscope (3 M ™ Littmann ® CORE stethoscope, Eko Device Inc, Oakland, CA) with Bluetooth technology was used to record sounds from two hip joints while performing an Ortolani sign.One dog had a palpable Ortolani sign with crisp reduction and no radiographic evidence of osteoarthritis.A second dog was similarly evaluated, but this dog had the sensation of crepitus during joint reduction and had radiographic evidence of osteoarthritis.Digital recordings were evaluated for possible differences.
Results: Graphical representations of both recordings were evaluated.
The dog with crepitus had a wider and higher amplitude graphical representation of joint sound compared to the dog without osteoarthritis, especially during reduction (Figs. 1 and 2).

Conclusion:
Based on these very preliminary results, audioarthrology may be a useful tool to characterize joint disease in a noninvasive, cost-effective manner.A clinical study of 50 canine joints is currently in progress to further characterize clinical applications of audioarthology.Normal and diseased elbow, stifle, and hip joints will be evaluated for acoustic waveforms.Background: Orthopedic conditions in dogs and cats include fractures of long bones which commonly require surgical repair for optimal outcomes [1,2].However, [1] depending on the patient's size, age, type of activity, fractured bone, and type of fracture, the orthopedist may opt for conservative treatment such as splints or bandages.With immobilization, disuse of the limb, muscle atrophy, joint blockage, and contraction of muscles, tendons, and ligaments are common [3], when joint changes are severe enough that they prevent the dog from functioning, arthrodesis and limb amputation are recommended [3,4].In these cases, the use of physiotherapy can be tried before surgery as it provides pain relief, muscle relaxation, reduces the inflammatory process, helps with bone healing, and improves joint movement, among other benefits [5,6].Quadriceps contractures are one of these conditions and are most frequently seen in puppies with distal femoral fractures [3,4].

Materials and methods:
A six month old female mixed breed dog presented with a lesion between the digits of the right foot secondary to a quadriceps contracture and dragging the foot.This was due to the utilization of an immobilizing splint for two months due to a fracture of the tibia (stifle was immobilized).The diagnosis of muscle contracture was based on the clinical examination (atrophy [circumference of the right thigh was 31 cm while the left thigh was 38 cm]), goniometry was 50° flexion on the left knee, 170° extension, and left tarsus: 60° flexion, 140° extension.In the injured limb, the knee flexion angle was 150°, extension, 180°; in the tarsus was: flexion 153°, extension 180° (Fig. 1).Examining the two limbs together using a counter-extension, a height difference of 8 cm was found.At the beginning of treatment, massage therapy techniques, pulsed electromagnetic field therapy (PEMF) to promote analgesia and muscle relaxation, joint mobilization were used to increase joint amplitude, in this case, decrease the flexion of the right knee and tarsus.Therapeutic exercise and hydrotherapy (Fig. 2) were included started at the 10th session.

Materials and methods:
A small mixed-breed dog was presented with off-loading the right hind leg.X-rays were taken and showed a non-union of the tibia.The dog's gait was initially evaluated on the instrumented treadmill to get a baseline before being treated with extracorporeal shockwave (focused) for three treatments weekly.Follow-up x-rays were taken four weeks after the last shockwave treatment.Gait analysis was performed before, after the third, final treatment, and four weeks after the previous treatment.The x-rays showed substantial bony changes after three treatments, the fracture gap had closed entirely.
Results: Extracorporeal shock wave treatment proved to help heal this non-union of the tibia within seven weeks.It is a non-invasive treatment, and it does not require anesthesia and, therefore, should be considered a conservative option to treat non-unions in dogs.

Conclusion:
These findings need to be followed by clinical studies to fully understand the biological mechanisms provoked by using extracorporeal-focused shock waves.
Results: In 100% of the population, it was shown reduction from severe pain (T0) to mild pain (F6).Also, it was demonstrated recovery of muscle mass, starting in T1, and improvement of flexion/ extension ROM of both joints, always with progressive evolution, similarly to other authors [2][3][4].Follow-up consultations over time were key in demonstrating the continuity of this improvement [5][6][7].
Comparing the present study with Cuervo et al. [8] by the one-sample t-test, it was shown a strong significance (t(7) = 2.518, P = 0.04), allowing comparison.Both studies had positive outcomes, although in the same study the long-term follow-ups were until 6 months, while in our study 4 dogs achieved 16 months.

Conclusions:
The protocol has fulfilled all the mentioned objectives and showed to be effective in dogs with osteoarthritis, with records of long-term follow-ups.It would be interesting to continue this study, achieving a higher number of dogs.

Materials and methods:
The patient was a 6-month-old, male, neutered pygmy goat (11.4 kg) that was bitten by a mule resulting in a thoracolumbar fracture at T11 (Fig. 1) with gas opacity seen and draining tract lesions bilaterally at T11-L1 with resultant bilateral paraplegia, which has also been documented in pygmy goats resulting from lymphosarcoma [2].Interventions included flunixin meglumine (Banamine) 0.2 ml SID, enrofloxacin (Baytril) 100 mg/mL, 1.0 ml sid, and dexamethasone 0.7 mL SID, all for 3 days at time of injury.
The patient was a household pet.Results: At initial rehabilitation evaluation, passive range of motion (ROM) using the normal convention for dogs [3] is reported in Table 1.The front limbs were normal.Neurological examination found an absence of conscious proprioception, motor function, and superficial and deep pain in the hindlimbs bilaterally.Panniculus reflex was absent from the T12 distal.Rear limbs were stiff when the range of motion test (Table 1) was performed, and contractures were developing in the hips, stifles, and tarsal joints.Cranial nerve examination was WNL.By discharge, the wounds were healed, the patient gained significant rear limb range of motion (Table 2), had no discomfort in any limb and was able to ambulate independently.).Exercises included thermotherapy for 15 min prior to passive ROM and stretching in the hindlimbs, assisted standing over peanuts, and cart fitting (Fig. 2).The cart allowed for independent ambulation with the rear limbs held in stirrups.As pygmy goats are not fully grown until approximately 3 years of age, readjustments and refitting of the cart will continue.The primary modification of the cart was lowering the leg rings to allow the patient to be in more a sitting position, widening the cart to allow for the width of the barrel of the patient, and padding to prevent skin breakdown.Background: Credible evidence supports that chiropractic treatment (CT) of equine spinal misalignments helps restore joint range of motion (ROM) [1] improving soft tissue function whilst diminishing pain [2].Myofascial release (MFR) acts by reducing myofascial constrictions [3], increasing spinal vertebrae joint ROM [4].The study aimed to objectively investigate the effect of CT and MFR treatments over time and to ascertain if combining these two therapeutic modalities produced a synergistic effect.The established method of Pressure Algometry (PA) was used to measure the mechanical nociceptor thresholds (MNTs), an indicator of musculoskeletal tenderness [1], of the thoracolumbar musculature of riding school horses.

Materials and methods:
This repeated measure study used 20 riding school horses with no known back pathologies, aged between 5 and 15 years (mean age 11.25 years ± 2.9 years).Random allocation to four groups (n = 5), control group (no intervention), chiropractic, myofascial release, and combined treatment groups.With Veterinary consent, all treatments were undertaken by a single qualified McTimoney animal practitioner.While the horses stood square, Research Assistant A measured MNTs bilaterally in triplicate, using an FDK-60 pressure algometer on the epaxial muscles located 10 cm ventral to the spine at T9, T13, L3, and L6.The results were recorded by Research Assistant B. Both research assistants were blinded to the treatment groups.The time points used were pre-treatment, post-treatment, Day 1, and Day 7 post-treatment.Data was tested for normality by the Kolmogorov-Smirnov test.Group data was analyzed over time points using the Kruskal-Wallis H test with post hoc tests.

Results:
The median range of all measuring points for the three consecutive measurements was 1-3 kg/cm 2 .There was no significant difference (P > 0.05) pre-treatment to Day 7 for neither the control nor MFR group.There was a significant increase in mean MNTs pre-treatment to Day 7 for both the CT and combined MFR & CT treatment groups, of 9.25% and 32.34% respectively.

Conclusion:
This study provides positive evidence that a single CT treatment and combined treatment of MFR and CT, illicit statistically significant reductions in musculoskeletal tenderness.Indicated by increased MNTs of specific equine thoracolumbar musculature, for up to 7 days, when compared to no treatment and MFR groups.Equine chiropractic practitioners may enhance their therapeutic outcome by delivering MFR immediately prior to CT.Further investigation is warranted with larger cohorts and over longer time periods.
Background: This paper will describe and illustrate, how the use of custom-made, low-temperature thermoplastic splints, can form part of the management of dogs with musculoskeletal and neurological diseases.There is a paucity of literature on the use of splinting as a part of the rehabilitation of small animals, and there is a need to disseminate the skills required to make custom-made splints.Materials and methods: Case descriptions will be used to illustrate different splints used in the management of a variety of pathologies.These will include Achilles tendinopathies and ruptures, carpal instability, peripheral nerve lesions, joint contractures, atlantoaxial instability, spinal surgery, and joint hypermobility.Material and design selection will be discussed in relation to specific cases.The manufacturing process of low temperature thermoplastic splints will be explained, as well as how the different properties of the materials give versatility in achieving differing outcomes for different cases.Use of neoprene in conjunction with thermoplastics will be included.

Results:
The selection of suitable cases will be contrasted with guidance around unsuitable cases, including the advantages and disadvantages of using splints against more traditional forms of cooptation.
Wearing regimes and follow-up will be covered.

Conclusion:
The use of bespoke splints in veterinary rehabilitation is a relatively new area for most practitioners.This paper suggests that there is a significant role in the appropriate use of splints, but that it is necessary to develop specific skills in relation to assessment for, selection, and manufacture.Further research and training opportunities will be required in order to establish splint making as a regular tool in the rehabilitation armory.Background: Ridden horses have increased muscle soreness, swelling and soft tissue lesions, particularly in the thoracolumbar region [1,2], leading to reduced mechanical nociceptive thresholds (MNT) [3].Not only is back pain performance limiting, it also compromises the animal's welfare [4].Electrotherapies have been shown to increase MNT values in horses [5], although there is emerging evidence to support the use of microcurrent in small animal and human studies [6][7][8][9] there is limited published evidence for use in horses.Figure 2 shows MNT values increased over the weeks, however RM-ANOVA showed there was no statistical significance for treatment/time p.22 or between treatments p. 94.One -way ANOVA showed time was significant P < 0.001 with the absolute values of change from baseline to end of intervention shown in Fig. 3. Ambient temperature confounded the results P < 0.001 with a positive correlation, Table 1 shows the interaction of temperature on MNT value per site.Figure 4 shows treatment group two appears to be less influenced by temperature.The effect of indirect and direct microcurrent on the throracolumbar region over time.

MNT readings Kg/cm2
Sites over time in weeks    Background: Given the multiple orthopaedic and neurological conditions affecting forelimb kinematics, it is vital to understand the impact of altering specific parameters on the underwater treadmill (UWTM), to improve clinical outcomes based on individual needs.The properties of water provide multiple advantages on canine limb kinematic and stride parameters [1][2][3][4].However, research which can quantitatively inform evidence-based practice regarding forelimb kinematics utilising an UWTM, is limited.The aims of this study were to objectively obtain baseline forelimb range of movement (carpus, elbow and shoulder), stride length and frequency measurements in healthy canine subjects at differing water depths, to provide guidance and assist therapists selecting appropriate parameters for their canine patient.Materials and methods: Kinematic analysis (2D) was utilised to assess range of movement of the canine shoulder, elbow, and carpus joints, alongside stride length and frequency.Eight medium to large breed dogs participated, free from musculoskeletal abnormalities, neurological or degenerative diseases.Reflective markers were placed on anatomical landmarks (dorsal border of spine of scapular, greater tubercle of the humerus, lateral epicondyle of the humerus, ulnar styloid process) and dogs walked at 2.4 m/s for 150-s at four water depths.Digital video cameras captured the data, and a video kinematic analysis tool was utilised to examine forelimb kinematics.A one-way repeated-measures ANOVA determined the effect of water depth on the range of movement of a canine's forelimb, stride length and frequency.Bonferroni correction was applied, where applicable.
Results: Carpus and shoulder peak flexion (PF) significantly increased when walking at various depths on the UWTM (Table 1).Carpus peak flexion was significantly lower when walking on the dry, with flexion increasing at all other water depths and most peak flexion produced at the mid-ulnar depth.Shoulder PF increased with higher water depths, with most shoulder PF produced at midhumerus water level.Water depth did not have a significant effect on peak flexion at the elbow, extension of all three forelimb joints, stride length or frequency.

Table 1 (abstract PO. 32) Significant values for pairwise comparisons for peak flexion at different water heights with confidence intervals in parenthesis
Conclusion: This investigation demonstrates the effect of differing water depths on range of movement of the forelimb joints (carpus, elbow and shoulder) and forelimb stride parameters.The findings illustrate the beneficial effects of adapting UWTM depth on range of movement, providing a greater insight into subsequent canine forelimb kinematics.The findings also provide therapists with valuable information for delivering hydrotherapy treatment to dogs with neuromusculoskeletal pathologies and provide further information on canine forelimb kinematics, which may benefit future research.

PO. 20 An investigation into the effect of canine footwear on locomotion
Emily Cooke 1 , Sarah Roberts Background: Boots are used on dogs to protect feet from injury while providing support, often with dogs working on uneven surfaces, such as search and rescue dogs [1] or for neurological cases where paw abrasion can occur [2].Gait, as a result of internal and external factors, such as the walking surface, the musculoskeletal system, and peripheral nervous system, must work in conjunction to adapt to this [3].The effects of external factors, such as shoes, have been researched extensively within the human and equine fields.However, there is limited research on the impact of boots on canine locomotion.Materials and methods: Ten healthy dogs were used in a cross-over design study.Participants were given time to habituate to equipment, researcher, and handler.Each dog performed five passes of the Gait-4Mat per regimen, with at least three gait cycles in each pass.Three regimens were conducted on different days: '1' without boots, '2' with boot type A (PawZ boots), and '3' with boot type B (Ruffwear Summit Trex boots).Participants returned on a separate day for each regimen, 24 h or more after the previous data collection.
Results: Mean GAIT4Dog Lameness Scores (GLS) were analysed using two-way ANOVA to establish the significance between boots, and forelimb and hind-limbs.Paired t-tests were used, comparing gait parameters and assessing symmetry.There was no significant difference found between total pressure index and boot application (P > 0.05).
A two-way ANOVA indicated that boot type did not have a significant difference on GLS (P > 0.05).However, there was a significantly higher GLS in the hind-limbs than the fore-limbs (P < 0.001) (Fig. 1); indicating canines off-loading weight to the hind-limbs when boots were applied, with boot type B demonstrating a significant greater response than boot type A (P = 0.019) when applied.The interaction (P = 0.019) between boot type and application on either FLs or HLs on GLS does indicate boots do have a significant effect on canine locomotion as weight redistribution is occurring.

PO. 21 The awareness, understanding, and opinions of animal physiotherapy amongst veterinarians based in Hong Kong (SAR)
Charlotte Davies 1 , Jo Ireland Background: β-hydroxy-β-methylbutyrate (HMB) is a metabolite of leucine that is known as one of the essential amino acids that activates the mammalian target of rapamycin complex 1 and increases protein synthesis [1,2].This study aimed to investigate the effects of HMB on muscle mass in dogs after orthopedic surgeries.Materials and methods: 18 dogs that underwent hind limb orthopedic surgeries (9 MPL, 3 TTA, 3 TPLO, 2 TTTA, and 1 CBLO) were divided into 2 groups.8 dogs were fed with HMB supplementation, and 10 were fed without HMB.Muscle mass of hind limbs was measured on days 0, 4, 10, and 30 postoperatively.Changing rates of muscle mass in 2 groups were compared by t-test, and the correlation between the changing rates of muscle mass and the daily protein intakes was assessed.
Results: Changing rates of muscle mass in the group with HMB were higher than in the group without HMB on Day10 (mean value of + 1.5% and -1.8% respectively, P < 0.05) and Day30 (mean value of + 6.8% and -2.1% respectively, P < 0.05).Also, daily protein intakes were potentially weakly correlated with the changing rates of muscle mass at Day10 (r = 0.206).Conclusion: HMB supplementation could prevent the muscle mass loss of the dogs who underwent orthopedic surgeries, postoperatively.Mean intakes of daily protein were the same in 2 groups.That may indicate that HMB increases protein synthesis and help better recovery.
Background: The Beighton scoring system is a commonly used tool for identifying hypermobility [1][2][3].Evidence shows that in a canine population there are links between joint laxity and pathologies such as hip dysplasia and patella luxation, but there is little evidence to connect the systemic presentation of hypermobility associated with variation in collagen histology [4].Ueda et al. demonstrated a positive correlation between abnormal collagen fibril distribution and a high SEI (more than the 14.5% reference value) in dogs with patella luxation [5,6].This study aimed to investigate SEI as part of the clinical picture of hypermobility.To look for evidence of hypermobility we investigated for correlation between skin extensibility index (SEI) and shoulder abduction or stifle extension ranges in healthy dogs.Materials and methods: A correlational study of 22 mixed breed dogs split into equal groups (n = 11) of SEI ≥ 14.5% indicating increased skin extensibility, or SEI < 14.5% without increased skin extensibility [6].Dogs were aged between 18-84 months and weighed between 8.7-35 kg.Shoulder abduction and stifle extension of bilateral limbs were measured in conscious dogs by an ACPAT veterinary physiotherapist using a goniometer.SEI was measured using a previously established method as seen in Fig. 1.0.Results: A correlation was found between SEI and both shoulder abduction (ρ = 0.512; P < 0.0001) and stifle extension (ρ = 0.600; P < 0.0001).T-tests showed statistically significant differences between the mean values across the two groups.Mean joint ranges and SEI scores are seen in Table 1.Conclusion: Joint range and SEI are positively correlated, and significantly higher joint ranges are found in dogs with an SEI of ≥ 14.5%.These parameters could be used as part of an assessment to indicate the presence of hypermobility in dogs given the previously demonstrated association between abnormal collagen fiber distribution, SEI, and patella luxation in dogs.Further research in a juvenile population of dogs would improve the relevance of these findings to the early diagnosis of hypermobility conditions.

PO. 24
Comparing veterinary professionals' opinions on the use of physiotherapy for surgically managed cranial cruciate ligament disease patients Hannah Taylor 1 , Sarah Roberts Confidence intervals were performed on single categorical questions to calculate the range within which the general population would fall, to a 95% confidence level.Open questions were evaluated by content analysis to identify common ideas and themes.Descriptive statistics (profession, gender, years since qualification) were cross-tabulated against categorical and coded open questions to identify relationships between responses using chi-squared analysis and Fisher's exact test.

Results:
The questionnaire gained responses from 50 veterinarians, 35 veterinary physiotherapists, and 29 hydrotherapists.The majority of CCLD patients were reportedly treated surgically by Tibial Plateau Levelling Osteotomy (TPLO) 96% of respondents have referred CCLD patients for physiotherapy, with 41.67% referring frequently (Fig. 1).Surgically managed patients were reportedly referred for physiotherapy more frequently than conservatively managed patients.Significantly more patients treated with osteotomies (P < 0.01), particularly TPLO (P < 0.05), were referred for physiotherapy than those undergoing soft tissue techniques.A significant difference existed between veterinary physiotherapists' current and recommended commencement of physiotherapy (P < 0.05), with 41.2% recommending beginning physiotherapy at an earlier stage (Fig. 2).

PO. 25
The effect of leg weights on stride length and range of motion in hind limbs of healthy dogs at the walk Anna Eriksson Svensson 1 , Ann Essner 2 , Wim Grooten Background: Using leg weights (LW), both with and without weights is a training method in the re-and prehabilitation of dogs.Previous research indicates increased range of motion (ROM) in the hind legs when using LW corresponding to 0.5% body mass (BM) in dogs at trot [1].The effect on ROM and stride length with LW at a walk and with lower weights is unclear, so as with empty LW.This study aimed to investigate the effects of empty LW and LW corresponding to 0.4% BM on stride length and ROM in hind limbs in healthy dogs walking on a treadmill.Materials and methods: Six dogs with a mean body weight of 23.8 kg (SD 5.7) and a mean age of 4.5 years (SD 2.7) were recorded at a sampling frequency of 30 frames per second in the sagittal plane when walking at a comfortable speed on a treadmill without LW, with empty LW proximal to the tarsus (Fig. 1) and with the added mass of 0.4% BM in the Before filming, The dogs had been acclimated the treadmill and the leg weights before filming.The placement of markers was standardized (Fig. 1).The recordings were analyzed in the movement analysis software Kinovea.Differences were estimated with the Friedmans test and post-hoc Wilcoxon Signed Rank test (P < 0.05).The dog's stress level and perceived exertion were also estimated during the study using the FAS-scale [2] and a perceived exertion scale for dogs [3].

Conclusion:
Empty LW can be used to increase stride length in healthy dogs walking on a treadmill.Further studies are needed to evaluate the effect of LW on ROM since the sample size was small in the present study.The methods here were well tolerated by the dogs and can be used in a protocol in future studies.

PO. 26
The effect different water levels have on muscle activation of the canine biceps femoris and vastus lateralis muscles in an underwater treadmill Amy Charnock 1 , Sarah Roberts Background: Aquatic therapy uses the properties of water for the rehabilitation and conditioning of the canine patient [1].It is important that veterinary physiotherapists and hydrotherapists understand the physiological effects underwater treadmills have, so that rehabilitation plans can be suitably tailored for the individual.Gait adaptations caused by walking on an underwater treadmill have been extensively researched in dogs and horses, with these effects presumably altering muscle activation [2][3][4].Currently, only one study has investigated the effects underwater treadmills have on canine muscle activity, which specifically looked at the Gluteus medius and longissimus dorsi muscles [5].It has previously been identified that more research into canine muscle activity using surface electromyography is required and with the quadriceps femoris and hamstrings making up a large portion of the hindlimb muscle mass [6,7].Materials and methods: Nine healthy Labrador Retriever and Labrador Retriever crosses were included in the study.Prior to data collection, all dogs were habituated to the underwater treadmill.Surface electromyography was used to detect muscle activity by placing electrodes over the vastus lateralis and biceps femoris muscle bodies.The treadmill was set at a comfortable walking speed for each dog (1.6 ± 0.12 m/s) with no water and water set at the height of the tarsal, stifle, and hip joints.Unfortunately, due to water interference, data was unable to be recorded at hip height.As muscle activation occurred at different stages in the gait cycle, the data was cropped at three points where the muscles were activated.This data was then transformed and analyzed using ANOVA to test for a significant difference between water height and muscle activity.Results: While water height influenced muscle activity, no significant difference was found for the biceps femoris muscle (P = 0.842), or the vastus lateralis muscle (P = 0.715).Results found that water height had opposite effects on muscle activity, with the biceps femoris muscle increasing and then decreasing in activity (Table 1), whilst the vastus lateralis muscle decreased and then increased in activity (Table 2).

PO. 27 Preliminary study to investigate effect of dog positioning on range of motion of elbow and hip joints in healthy dogs
Justyna Mucha, Sarah Roberts Background: Range of motion (ROM) measurements of joints are used by physiotherapists to support the development of treatment plans and monitor progression after intervention [1].ROM measurements in dogs are performed in both standing and lateral recumbency [2].
There are no studies investigating the effect of dog positioning on ROM.This requires further investigation to consider whether standing and lateral recumbency positions can be used interchangeably to make appropriate comparisons between patients [3].Materials and methods: An experimental approach was chosen as the design, adapted from Jaeger et al. [4].Healthy Labrador Retrievers were selected using convenience sampling, with the sample size of four being determined by utilizing the coefficient of variation from the aforementioned study [4].Flexion and extension ROM of one elbow and the ipsilateral hip joint were measured with a universal goniometer (Figure 1) in standing and lateral recumbency positions.The side of measurement was designed to be randomly chosen by a draw for the first participating dog and alternated for each consecutive participating dog.All joint positions were measured three times each by one tester.

Figure 1 (abstract PO. 27) Universal goniometer
Results: The gross data measurements can be seen in Table 1.Mean, and standard deviation (SD) were calculated for data sets that were normally distributed, and median and interquartile ranges were calculated for data sets that were abnormally distributed.The parametric matched pairs t-test was used to determine if dog positioning had a statistically significant effect on the ROM measurements for data sets that were normally distributed, and the nonparametric Wilcoxon matched pairs test was used to determine if dog positioning had a statistically significant effect on the ROM measurements for data sets that were abnormally distributed.The results were considered statistically significant when the probability (P) was less than 0.05.Data from the elbow flexion measurements were highly skewed (1.05), and data from the elbow extension, hip flexion, and hip extension measurements were only slightly skewed (0.21, -0.09, and -0.11, respectively) (Table 2).None of the ROM measurements was statistically significantly affected by the dog positioning.Background: Sit-to-stand and stand-to-sit motions are essential for the daily life of animals.These motions are a therapeutic exercise following musculoskeletal and neurological disorders [1].However, muscle activity of these motions has not been well examined yet.This study aimed to characterize muscle activities of the hindlimb extensors during sit-to-stand and stand-to-sit motions.For this purpose, we measured the Gluteus medius (GM), Vastus lateralis (VL), and Gastrocnemius (GC) muscle activities using surface electromyography (sEMG) because these are major extensor muscles of the hip, stifle, and tarsal joints.Materials and methods: Six clinically sound beagles aged between 4 and 8 years were used.After being habituated to walking on a treadmill, we acquired data for 10 valid gait cycles set at 0.7 m/sec and 5 trials of sit-to-stand and stand-to-sit motions.Muscle activities were sampled using a sEMG (Noraxon, Scottsdale, AZ) with a kinematic motion analysis system [2][3][4].The obtained muscle activity signals were rectified, smoothed, and filtered.The amplitude of sEMG during sit-to-stand and stand-to-sit motions was normalized by the average of the maximum amplitude in 10 gait cycles.The difference between the motions was compared using the Wilcoxon signed-rank test.Significance was set at P < 0.05.Since walking is also a general therapeutic exercise, the muscle activities during the sit-to-stand and stand-to-sit motions were compared with those of walking to clarify the difference between the motions.Results: The maximum activities of three muscles during the sit-tostand and stand-to-sit motions tended to be high compared with walking (Fig. 1).During the sit-to-stand, the %EMG of the VL was higher than that of the stand-to-sit.On the other hand, the %EMG of the GC during sit-to-stand was lower than that of the stand-to-sit.Although the %EMG of the three muscles was similar in the stand-tosit motion, the VL muscle activity tended to be higher than that of the other muscles during sit-to-stand (Fig. 2).The peak of VL muscle activity appeared in the first half of the sit-to-stand motion.

Conclusion:
The results indicated the characteristics of the hindlimb muscle activities during the sit-to-stand and stand-to-sit motions of dogs.The first half of the sit-to-stand motion strengthened the VL muscle activity, and the stand-to-sit enhanced the well-coordinated hindlimb extensor muscles compared to walking.Knowing the hind limb extensor muscle activities during sit-to-stand and stand-to-sit motions might help practitioners conduct precise rehabilitation for an individual patient.This case study was designed to highlight the need for change in clinical treatment practices to include a physiotherapy 'whole horse' approach in order to more effectively treat SDFT strains.The goal of using a team approach by combining physiotherapy, farrier and veterinary treatments is to safely return the horse to ridden canter work without reinjury.

Materials and methods:
The patient was a 15-year-old Warmblood gelding ridden in competitive show jumping which has sustained bilateral SDFT strains and a recurrence of strain in the right front SDFT (Fig. 1).He was treated biweekly by a physiotherapist (Diploma Animal Rehab, Equine) over a 5 month period.They included manual therapy/joint mobilizations [3], deep transverse frictions, myofascial release [4], continuous and pulsed ultrasound, core strengthening exercises [5] including resistance bands [6] and weighted hoof boots [7], proprioception/balance exercises [8], in hand and ridden pole exercises [8], a novel application of eccentric, concentric, and speed loading exercises [9][10][11], in hand and ridden hill work, and moving from firm to deeper footing.Concurrent veterinary treatment included platelet-rich plasma injection with immediate shock wave application followed by 2 subsequent shock wave treatments 2 weeks apart and a conservative walk-trot-canter-ridden protocol.Concurrent farrier work included corrective trimming to increase ease of roll-over and application of 'suspensory' aluminum shoes on four feet.Objective measures used were: range of motion using photographs, lameness examinations, diagnostic ultrasound, hoof x-rays, and the functional outcome of returning to walk, trot, and canter, ridden work.Physiotherapy treatment goals were to restore full range of motion in all joints and myofascial tissues, core strength, and conditioning, balance and proprioception, and SDFT elasticity during eccentric, concentric, and speed loading in order to return the horse to ridden flatwork without reinjury (Fig. 2).

Results:
The patient was successfully returned to ridden canter work and will continue to be able to be ridden for dressage performance and flat work.Due to the extent of the soft tissue injury, the delay in the inclusion of conservative physiotherapy rehabilitation, and having sustained 2 injuries successively to the right SDFT, it is unreasonable to return the patient to jumping activities in the future.Conclusion: Rehabilitation of recurrent SDFT injuries is more effective using combined 'whole horse' physiotherapy, veterinary and farrier treatments for a successful return to ridden work.It is recommended that a team approach be applied and further studied, to improve the health of performance horses with SDFT injuries.

Consent to publish
Informed consent was obtained from the horse's owner prior to the start of the study, and there was adherence to a high standard (best practice) of physiotherapy, farrier, and veterinary care.Introduction: Lameness in horses is a gait abnormality; the limb is unloaded to relieve pain resulting from musculoskeletal injury or mechanical restrictions [1].Gold standard lameness quantification is suggested as subjective analysis by veterinarians alongside gait analysis from an inertial sensor system [2,3], which can only be achieved when the owner or handler recognizes a problem.This study aimed to investigate the general UK equestrian population's ability to detect lameness in horses, and any relationships between the ability to detect lameness and other lifestyle factors.Materials and methods: Video footage was obtained from five lameness workups at an equine hospital; each horse was assessed in walk and trotting along hard surfaces.Lameness diagnoses were made using subjective gait analysis from experienced veterinarians and inertial gait analysis equipment.An online questionnaire was used to obtain responses from across the UK.Previous experience of lameness and years of experience with horses were analyzed one-way ANOVA then a post-hoc Bonferroni test; experience rating with horses using Kruskal Wallis one-way analysis of variance then post-hoc Mann Whitney; the nature of their involvement with horses, were compared to the number of correct lameness identifications scored out of the five videos using U-tests, a chi squared test, two sample T-test.
Results: 400 responses were obtained.A significant difference (SD) was observed in participants' involvement with horses and score of correct lameness identifications (χ 2 = 54.2007,d.f.=6, P=0.00001); clinicians scored higher than all other groups (Figure 1).SD existed (χ 2 = 15.08,d.f.=4, P=0.0045) in lame limb identification scores between the group with 0-9 years of experience and other groups (Figure 2).An SD was observed between a group of participants previously seeing lameness in horses and the group of participants who had not (χ 2 = 19.138,d.f.=1, P=0.000012) (Figure 3).An SD was observed between participants' experience rating and their score of correct lameness identifications (χ 2 = 16.56,d.f.=4, P=0.002), with a rating of 'good' getting a better score of correct lame limb identifications than a rating of 'average' or 'poor' .Introduction: Foals are expected to stand up within two hours after birth: delays could be a sign of illness.The progress of standing-up behavior has not been reported previously, despite its possible clinical significance, thus this observational pilot study was performed.Materials and methods: Two healthy colts (one Finnhorse (F)) and one Finnish Warm Blood (FWB)) were video recorded from birth to 12 h of age.Attempts to stand up and standing up were recorded as total numbers of behaviors using the CowLog-behavioral coding software [1].

Conclusion:
Foals tried to stand shortly after birth.Many attempts were needed before foals were able to stand up the first time, but fewer attempts were needed for the following stands.There was a lot of variance in attempts needed between each stand, and between foals.Thus, further studies with more foals are needed with a longer monitoring period.

Figure 1 (
Figure 1 (abstract O.07) Bar chart of mean joint flexion and extension ROM for age groups (*denotes significance difference between groups) Conclusion: Bilateral ROM measures of fore and hind quarters are important to consider in joint movement assessment.Joints can show different preferences in the asymmetry of passive ROM.This warrants further investigation with larger cohorts of defined age groups and could have implications in monitoring limb joint function of dogs.

Figure 1 (Figure 2 (
Figure 1 (abstract O.14) The lameness grade for each horse was assessed in pre-treatment and post-treatment orthopedic examinations

References 1 .
Adams B, Chan A, Callahan H, Milgram NW.The canine as a model of human cognitive aging: recent developments.Prog Neuropsychopharmacology Biol Psychiatry.2000; 24:675-92.2. Fast R, Schütt T, Toft N, Møller A, Berendt M.An observational study with long-term follow-up of canine cognitive dysfunction: clinical characteristics, survival, and risk factors.J Vet Intern Med.2013.

Figure 1 (Figure 2 (
Figure 1 (abstract PO. 11) Acoustic recording from a dog with an Ortolani sign and no radiographic osteoarthritis.The smaller first peak represents subluxation of the hip, and the second larger peak represents reduction of the joint in case of quadriceps muscle contracture without previous surgical treatment Daniela Loureiro Henrique 1 , Beatriz Ribeiro Gaspar2, Júllia de Almeida Lima 3 , Fernanda Vituri 4 , Daniel Chechinatto 1 , Luis David Solis Murgas 5 1 PhD student in Animal Physiology and Metabolism at Federal University of Lavras; 2 Student at the University of São Paulo (USP).São Paulo-SP Brazil; 3 Student at the Federal University of Lavras (UFLA) Lavras-MG Brazil; 4 Veterinary Physician with specialization in Physiotherapy and Veterinary Orthopedics; 5 Titular Professor Department of Veterinary Medicine at the Federal University of Lavras (UFLA) Lavras-MG Brazil Correspondence: Daniela Loureiro Henrique (daniela@pataepatela.com.br) Acta Veterinaria Scandinavica 2023, 65(Suppl 1):PO.12

Figure 1 (Figure 2 (
Figure 1 (abstract PO. 15) Fracture at T11 with draining tracts Table 1 (abstract PO. 15) Passive range of motion at initial evaluation L Flex L Ext R Flex R Ext L Total ROM R Total ROM Hip 30°67°50°75°37°25°S tifle 15°90°20°85°75°65°T arsus 90°150°70°140°60°70°L eft = L, Right = R, Flex = Flexion, Ext = Extension Table 2 (abstract PO. 15) Passive range of motion at discharge (3 months after initial evaluation) L Flex L Ext R Flex R Ext L Total ROM R Total ROM Hip 30°140°25°105°110°80°S tifle 15°100°15°110°85°95°T arsus 30°152°25°140°122°115°L eft = L, Right = R, Flex = Flexion, Ext = Extension Pressure algometer (PA) is a reliable quantitative method to measure MNT values in horses with back pain[10][11][12], although it is known circadian rhythms affect PA readings [13], the effects of time and environmental factors on MNT's are still relatively unknown.The objective of this study was to evaluate the effects of direct and indirect microcurrent therapy on MNT's in the healthy ridden horse and test the hypothesis that MCT can improve healing by increasing MNT values.Materials and methods: Baseline PA readings were taken from 10 bilateral soft issue landmarks[3]  (Fig.1) from 16 healthy ridden horses then the same day weekly between 3.30-5.30pm.Horses were randomly assigned to one of two treatment groups.Treatment group one indirect-ArcEquine microcurrent device, applied to alternate lower hind limbs daily for three hours per day/6 weeks following manufactures guidelines.Treatment group two direct-MT-330 microcurrent device placed on the thoracolumbar region for one hour per day/ 4 weeks.Both devices require wetting of the coat and applying a water based conductive gel to the site of the electrode.The PA was operated by the authors, data recording was collected blind by a second person.Results: One horse was withdrawn from treatment group one due a skin reaction at the site of the electrodes.Sites six and eight had lower mean ± s.d baseline readings.

Figure 1 (
Figure 1 (abstract PO. 19) A left side schematic representation of the 10 bilateral thoracolumbar sites

Figure 2 (Figure 3 (
Figure 2 (abstract PO. 19)The effect of treatment 1 (indirect) and treatment 2 (direct) on all sites over the assessment time in weeks.MNT readings (kg/cm2) per site, values displayed as mean ± s.e obtained through RM-ANOVA

1 1
Animal Health, Behavior and Welfare Department, Harper Adams University, Edgmond, Shropshire, TF10 8NB, UK Correspondence: Sarah Roberts (broberts@harper-adams.ac.uk)Acta Veterinaria Scandinavica 2023, 65(Suppl 1):PO.24 Background: Cranial cruciate ligament disease (CCLD) is the fourth most common musculoskeletal condition in the UK canine population, estimated to affect 1.24% of dogs[1].The management of CCLD has advanced with the development of osteotomy surgeries; this progression highlights the importance of post-operative physiotherapy[3].However, the current implementation of post-operative physiotherapy in CCLD patients is lacking in research.Materials and methods: A questionnaire was developed using Bristol Online Surveys and distributed by email to 1078 veterinary practices on the Royal College of Veterinary Surgeons (RCVS) 'Find a Vet' database, 207 members of the 'National Association of Veterinary Physiotherapists' and 156 members of the 'Canine Hydrotherapy Association' .The questionnaire used categorical, multiple choice, list, ranking, and open questions to achieve the study objectives.

Figure 1 (Figure 2 (
Figure 1 (abstract PO. 24) Bar Chart illustrating frequency of veterinary referral of CCLD patients for physiotherapy

Figure 1 (
Figure 1 (abstract PO. 25) Placement of LW and markers in the dogsResults: During a walk on a treadmill with empty LW, stride length in the hind limbs increased significantly (P = 0.027) compared to no LW applied.The mean difference was 1.7 cm (SD 3.5 without LW and 3.7 with empty LW).There was no difference between LW corresponding to 0.4% BM compared to no LW.Further, there was no significant change in ROM in tarsal, stifle or hip joints with empty or loaded LW.The methods in this study were well tolerated by all dogs.

Figure 1 (Figure 2 (
Figure 1 (abstract PO. 28) Comparison of activities of the Gluteus medius (GM), vastus lateralis (VL), and gastrocnemius (GC) muscles during walking, sit-to-stand, and stand-to-sit motions.The sit-to-stand and stand-to-sit represented %EMG was normalized by the maximum amplitude of walking.Asterisk indicates a significant difference (P < 0.05) between sit-to-stand and stand-to-sit

Figure 1 (Figure 2 (Figure 3 (
Figure 1 (abstract PO. 30) The effect of the participants' main involvement with horses on their number of correct limb lameness identifications in the questionnaire Results: First attempts to stand occurred 3 (F) and 4 min (FWB) after birth.Foals tried 73 (F) and 50 (FWB) times before first actual standing up.For the second try, they needed 4 (F) and 3 (FWB) attempts.The attempts per standing up varied between 0 and 35 (F), and 0 and 25 (FWB), with a median of 2 and 4, respectively.During the first 12 h, foals attempted to stand altogether 157 (F) and 118 (FWB) times and they stood up 11 (F) and 10 (FWB) times.

11 Inter-rater reliability of grading soft tissue palpation of the thoracolumbar epaxial musculature of endurance horses during competition Fiona Bloom 1
, Euan Bennet 2 , Stephen Draper 1 , Gillian Tabor 1 , David Marlin 3 , Jane Williams 1 1.15-4.62,P= 0.018) and increased odds of lameness (Odds ratio 4.16, 95% CI 1.92-9.01,P< 0.001).Conclusions: Asymmetrical back palpation scores during endurance competitions are a significant risk factor for elimination, specifically lameness elimination during British national endurance competitions.Higher palpation scores, associated with pain response, were found to be significantly different in terms of elimination and lameness when compared to palpation scores considered normal or slightly hypertonic.This indicates back pain in endurance horses during competition should be further investigated to minimize the risk of lameness eliminations and optimize welfare.O.

65(Suppl 1):PO. 01
pated in at least three hours of sport-specific training per week, and only a small portion (n = 8, 1%) trained in their specific sport less than once per week.The median total workload for the dogs, i.e., daily exercise, vigorous exercise, and sport-specific training, was 16.8 h per week.Of the dogs practicing one discipline, 5.2% (n = 83) were considered specialized since they actively trained in that one discipline for ≥ 10 months per year.Conclusion: Our findings provide valuable insights into cultural differences between Swedish working trial dogs and previous studies on agility dogs; based on the physical activity and sport-specific training patterns, the working trial dogs in Sweden were moderate to highly active.Further studies regarding the risk and protective factors of injuries in competing working dogs are required.Background: Knowledge regarding specific training towards various disciplines and specialization in sporting and working trial dogs is lacking.This study aimed to explore sport-specific training patterns among Swedish dogs competing in agility, obedience, rally obedience, and working trial disciplines.Materials and methods: Dog handlers provided information on competition-level dogs through an internet-based survey on physical activity, sport-specific training, and management variables.
: A retrospective internet-based survey collected data from 280 owners of 357 dogs in the UK.The data was analyzed using a Pearson Chi-Squared test via two-by-two contingency tables to calculate the relative risk of injury for different breeds and the age at which agility training commenced.Results: Soft tissue injuries are more common in agility dogs than joint injuries, with the shoulder area most vulnerable to damage.Border Collies have an increased risk of sustaining an injury compared with other breeds but are less likely to injure their shoulder area.Dogs who began their agility preparation in the age range of 5 to 10 months compared with dogs of the age range of 20 to 25 months experienced a reduced risk of injury.Conclusion: To impact the incidence of injury, more research is needed in this area to ascertain the mechanics of how dogs negotiate an agility course.Owners, Veterinary Surgeons, and other members of the multidisciplinary team may have a positive effect on injury reduction by increasing the length of time spent on the physical preparation of the dog before starting the competition.
Reference 1. Levy I, Hall C, Trentacosta N, Percival M. A preliminary retrospective survey of injuries in dogs participating in canine agility.Vet Comp Orthop Traumatol.2009; 22: 321-24.PO. 04 Improvements in pain and stiffness in dogs with osteoarthritis using a therapeutic dog mattress Matthew Brunke 1 , Kimberly Christie 1 , Jennifer Barnhard 1 , Heather Scavello 2 1 Veterinary Surgical Centers Rehabilitation, Vienna, Virginia, USA; 2 University of Pennsylvania, School of Veterinary Medicine, Veterinary Clinical Investigations Center, Philadelphia, Pennsylvania, ISA Correspondence: Matthew Brunke (drmattbrunke@gmail.com) Acta Veterinaria Scandinavica 2023, 65(Suppl 1):PO.04 1, Fernanda Vituri 1 , Daniela Loureiro Henrique 2 1 Instituto Amarelo Vet, São Paulo, São Paulo, Brazil; 2 Universidade Federal de Lavras, Minas Gerais, Brazil The use of laser therapy is a highly effective tool when used to assist in cases of open wound healing.Due to its biological effects, such as granulation stimulation, epithelialization, and other cell growth factors, this technique accelerates the healing time in relation to the average time when there is no associated technique.
1, Inês Roque do Vale 2 , Ana Cardoso 2 , Carla Carvalho 1 , Oscár Gamboa 4 , António Ferreira 4,5 , Rute Canejo-Teixeira 3 , Ângela Martins 2,3 1 Arrábida Veterinary Hospital-Arrábida Animal Rehabilitation Center, 2925-538, Azeitão, Setúbal, Portugal; 2 Superior School of Health, Correspondence: Débora Gouveia (vetarrabida.lda@gmail.com)Acta Veterinaria Scandinavica 2023, 65(Suppl 1):PO.14 Background: The veterinarian and physiotherapist used published resources as well as advice from experienced colleagues to cooperate during the horse's management and provide the best guidance to the owner.Results: Video and photographic footage are available to supplement the verbal description of the lameness and rehabilitation.The veterinarian and physiotherapist used published resources as well as advice from experienced colleagues to cooperate during the horse's management and provide the best guidance to the owner.
by an equine veterinarian and physiotherapist working together to evaluate an unusual lameness observed in the field, and retrospective considerations on how to manage such a case in the future.Video and photographic footage are available to supplement the verbal description of the lameness and rehabilitation.2McTimoneyCollege of Chiropractic, Abingdon, Oxford, UK Correspondence: Elizabeth Wenman (diane.grosjean@ugent.be)Acta Veterinaria Scandinavica 2023, 65(Suppl 1):PO.17

abstract PO. 19) The effect size, represented by a com- parison of mean difference of improvement between groups before and after temperature prediction adjustments (obtained from Unbalanced -ANOVA) Conclusion:
Direct and indirect microcurrent were unable to increase MNT values in the healthy ridden horse.Temperature affected MNT values.

Table 2 (abstract PO. 26) Mean muscle activation for the vastus lateralis muscle
This study demonstrates that while water height affects muscle activity, it does not cause a significant difference.It highlighted the fact that the biceps femoris and vastus lateralis muscles respond differently to water height, in relation to the muscle's action in the gait cycle.Future research is required with larger samples to establish if there is a significant difference in muscle activation.1. Houlding B. Canine hydrotherapy: where are we now?Vet Rec.2011; 168:405-6.2. Barnicoat F, Wills AP.Effect of water depth on limb kinematics of the domestic dog (Canis lupus familiaris) during underwater treadmill exercise.Comp Exerc Physiol.2016; 12:199-207.

Table 2 (abstract PO. 27) The statistical results of the effect of dog positioning on elbow and hip range of motion measurements in flexion and extension in four healthy dogs
References 1 Clegg PD.Musculoskeletal disease and injury, now and in the future.Part 2: Tendon and ligament injuries.Equine Vet J. 2012; 44:371-5.2 Goff L. Physiotherapy assessment for the equine athlete.Vet Clin North Am Equine Pract.2016; 32:31-47.3 Haussler KK.Equine manual therapies in sport horse practice.Vet Clin North Am Equine Pract.2018; 34:375-89.4 Elbrønd VS, Schultz RM.Deep myofascial kinetic lines in horses, Comparative Dissection Studies Derived from Humans.Open J Vet Med.2021; 11:14.5 Clayton HM, Kaiser L, Lavagnino M, Stubbs N. Evaluation of intersegmental vertebral motion during performance of dynamic mobilization exercises in cervical lateral bending in horses.Am J Vet Res.2012; 73:1153-9.6 Pfau T, Simons V, Rombach N, Stubbs N, Weller R. Effect of a 4-week elastic resistance band training regimen on back kinematics in horses trotting in-hand and on the lunge.Equine Vet J. 2017; 9:829-35.7 Jensen AM, Ahmed W, Elbrønd VS, Harrison AP.The efficacy of intermittent long-term bell boot application for the correction of muscle asymmetry in equine subjects.J Equine Vet Sci.2018; 68:73-80.